Essential medicine selection during the COVID-19 pandemic: Enabling access in uncharted territory
- Authors: A G Parrish
- Date: 2020
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/3364 , vital:43319 , http://www.samj.org.za/index.php/samj/article/view/13086
- Description: The COVID-19 pandemic requires urgent decisions regarding treatment policy in the face of rapidly evolving evidence. In response, the South African Essential Medicines List Committee established a subcommittee to systematically review and appraise emerging evidence, within very short timelines, in order to inform the National Department of Health COVID-19 treatment guidelines. To date, the subcommittee has reviewed 14 potential treatments, and made recommendations based on local context, feasibility, resource requirements and equity. Here we describe the rapid review and evidence-to-decision process, using remdesivir and dexamethasone as examples. Our experience is that conducting rapid reviews is a practical and efficient way to address medicine policy questions under pandemic conditions.
- Full Text:
- Authors: A G Parrish
- Date: 2020
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/3364 , vital:43319 , http://www.samj.org.za/index.php/samj/article/view/13086
- Description: The COVID-19 pandemic requires urgent decisions regarding treatment policy in the face of rapidly evolving evidence. In response, the South African Essential Medicines List Committee established a subcommittee to systematically review and appraise emerging evidence, within very short timelines, in order to inform the National Department of Health COVID-19 treatment guidelines. To date, the subcommittee has reviewed 14 potential treatments, and made recommendations based on local context, feasibility, resource requirements and equity. Here we describe the rapid review and evidence-to-decision process, using remdesivir and dexamethasone as examples. Our experience is that conducting rapid reviews is a practical and efficient way to address medicine policy questions under pandemic conditions.
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But is it publishable? Mastering the MMed message
- Authors: A G Parrish , E S Grossman,
- Date: 202
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/3353 , vital:43318 , http://www.samj.org.za/index.php/samj/article/view/13033
- Description: The research requirement for South African specialist registration offers opportunities and challenges. For some clinicians it may spark a lifelong interest in clinical investigation, while for many others it may provide a potential publication opportunity. Integrating the specific requirements of an MMed mini-dissertation with those of standard medical publications can be difficult for first-time authors and their supervisors; published guidance caters to full-length laboratory Master’s or doctoral research. We suggest that research is more likely to be publishable if it is locally relevant, has a clear clinical message and is coherently presented.
- Full Text:
- Authors: A G Parrish , E S Grossman,
- Date: 202
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/3353 , vital:43318 , http://www.samj.org.za/index.php/samj/article/view/13033
- Description: The research requirement for South African specialist registration offers opportunities and challenges. For some clinicians it may spark a lifelong interest in clinical investigation, while for many others it may provide a potential publication opportunity. Integrating the specific requirements of an MMed mini-dissertation with those of standard medical publications can be difficult for first-time authors and their supervisors; published guidance caters to full-length laboratory Master’s or doctoral research. We suggest that research is more likely to be publishable if it is locally relevant, has a clear clinical message and is coherently presented.
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Point-of-care and lung ultrasound incorporated in daily practice
- Neethling, E, Roodt, F, Beck, C, Swanevelder, J L C
- Authors: Neethling, E , Roodt, F , Beck, C , Swanevelder, J L C
- Date: 2018
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/5248 , vital:44424 , http://www.samj.org.za/index.php/samj/article/view/12293
- Description: Point-of-care ultrasound (POCUS) is a fast-growing clinical utility and is becoming an essential clinical skill for all practitioners attending to critically ill patients. Ultrasound equipment is now smaller, more affordable and readily available in clinical work areas. POCUS is performed by a non-cardiologist physician at the patient’s bedside as an adjunct to the physical examination. It is easily taught, non-invasive and allows for real-time clinical information. Bedside use of ultrasound imaging aids with rapid diagnosis of severe and life-threatening pathological conditions. It can be repeated, may change clinical management, and impact on patient outcome. POCUS has a broad clinical use, including, but not limited to, focused assessed transthoracic echocardiography (FATE), lung ultrasound imaging, extended focused assessment with sonography for trauma (e-FAST), vascular access and regional blocks. It may also be extended to detect endotracheal intubation and the estimation of intracranial pressure. Assessment of cardiac pathology by POCUS, performed by a novice examiner, has been shown to compare with the gold standard of an expert. Training is paramount. The physician should know his limitations and always relate the information back to the clinical scenario and context. By incorporating POCUS as part of our armamentarium and into our daily medical practice, we might see it reach its full clinical potential, optimising patient care and improving patient outcomes.
- Full Text:
- Authors: Neethling, E , Roodt, F , Beck, C , Swanevelder, J L C
- Date: 2018
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/5248 , vital:44424 , http://www.samj.org.za/index.php/samj/article/view/12293
- Description: Point-of-care ultrasound (POCUS) is a fast-growing clinical utility and is becoming an essential clinical skill for all practitioners attending to critically ill patients. Ultrasound equipment is now smaller, more affordable and readily available in clinical work areas. POCUS is performed by a non-cardiologist physician at the patient’s bedside as an adjunct to the physical examination. It is easily taught, non-invasive and allows for real-time clinical information. Bedside use of ultrasound imaging aids with rapid diagnosis of severe and life-threatening pathological conditions. It can be repeated, may change clinical management, and impact on patient outcome. POCUS has a broad clinical use, including, but not limited to, focused assessed transthoracic echocardiography (FATE), lung ultrasound imaging, extended focused assessment with sonography for trauma (e-FAST), vascular access and regional blocks. It may also be extended to detect endotracheal intubation and the estimation of intracranial pressure. Assessment of cardiac pathology by POCUS, performed by a novice examiner, has been shown to compare with the gold standard of an expert. Training is paramount. The physician should know his limitations and always relate the information back to the clinical scenario and context. By incorporating POCUS as part of our armamentarium and into our daily medical practice, we might see it reach its full clinical potential, optimising patient care and improving patient outcomes.
- Full Text:
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